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Abstract Background Currently, different guidelines recommend using different methods to determine whether deduplication is necessary when determining the detection rates of multidrug-resistant organisms (MDROs). However, few studies have investigated the effect of deduplication on MDRO monitoring data. In this study, we aimed to investigate the influence of deduplication on the detection rates of MDROs in different specimens to assess its impact on infection surveillance outcomes. Methods Samples were collected from hospitalized patients admitted between January 2022 and December 2022; four types of specimens were collected from key monitored MDROs, including sputum samples, urine samples, blood samples, and bronchoalveolar lavage fluid (BALF) samples. In this study, we compared and analysed the detection rates of carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Escherichia coli (CRECO), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and methicillin-resistant Staphylococcus aureus (MRSA) under two conditions: with and without deduplication. Results When all specimens were included, the detection rates of CRKP, CRAB, CRPA, and MRSA without deduplication (33.52%, 77.24%, 44.56%, and 56.58%, respectively) were significantly greater than those with deduplication (24.78%, 66.25%, 36.24%, and 50.83%, respectively) (all P

Background: Currently, different guidelines recommend using different methods to determine whether deduplication is necessary when determining the detection rates of multidrug-resistant organisms (MDROs). However, few studies have investigated the effect of deduplication on MDRO monitoring data. In this study, we aimed to investigate the influence of deduplication on the detection rates of MDROs in different specimens to assess its impact on infection surveillance outcomes. Methods: Samples were collected from hospitalized patients admitted between January 2022 and December 2022; four types of specimens were collected from key monitored MDROs, including sputum samples, urine samples, blood samples, and bronchoalveolar lavage fluid (BALF) samples. In this study, we compared and analysed the detection rates of carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Escherichia coli (CRECO), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and methicillin-resistant Staphylococcus aureus (MRSA) under two conditions: with and without deduplication. Results: When all specimens were included, the detection rates of CRKP, CRAB, CRPA, and MRSA without deduplication (33.52%, 77.24%, 44.56%, and 56.58%, respectively) were significantly greater than those with deduplication (24.78%, 66.25%, 36.24%, and 50.83%, respectively) (all P < 0.05). The detection rates in sputum samples were significantly different between samples without duplication (28.39%, 76.19%, 46.95%, and 70.43%) and those with deduplication (19.99%, 63.00%, 38.05%, and 64.50%) (all P < 0.05). When deduplication was not performed, the rate of detection of CRKP in urine samples reached 30.05%, surpassing the rate observed with deduplication (21.56%) (P < 0.05). In BALF specimens, the detection rates of CRKP and CRPA without deduplication (39.78% and 53.23%, respectively) were greater than those with deduplication (31.62% and 42.20%, respectively) (P < 0.05). In blood samples, deduplication did not have a significant impact on the detection rates of MDROs. Conclusion: Deduplication had a significant effect on the detection rates of MDROs in sputum, urine, and BALF samples. Based on these data, we call for the Infection Prevention and Control Organization to align its analysis rules with those of the Bacterial Resistance Surveillance Organization when monitoring MDRO detection rates. [ABSTRACT FROM AUTHOR]

Objective: To investigate value of myeloid differentiation factor 88（ MyD88） pathway molecules in different specimens in predicting viral reactivation after hepatitis B virus（ HBV） infection-related hepatocellular carcinoma, to predict risk of postoperative viral reactivation and accurately identify high-risk patients for clinicians and to guide clinical targeted intervention. Methods: A total of 82 patients with liver cancer related to HBV infection who were admitted in Xinyang 154 Hospital from January 2017 to January 2021 were divided into reactivated group and non-reactivated group according to whether virus was reactivated one month after operation, and MyD88 pathway molecules MyD88, interleukin-1 receptor related kinase 1 （IRAK1）, tumor necrosis factor receptor related factor 6 （TRAF6）, transforming growth factor-β activated kinase 1 （TAK1）, interferon regulatory factor 7 （IRF7） mRNA expressions in liver cancer tissues, numbers of peripheral blood mononuclear cells （PBMCs）, plasmacytoid dendritic cells （pDCs）, MyD88 pathway molecules experissions in PBMCs and pDCs of two groups were compared. Receiver operating characteristic curves （ROC） and area under ROC （AUC） were used to analyze value of MyD88 pathway molecules in different specimens to predict postoperative viral reactivation. Results: There was no significant difference in expressions of MyD88, IRAK1, TRAF6, TAK1, IRF7 mRNA in two groups of liver cancer tissues （P>0.05）; numbers of PBMCs and pDCs in peripheral blood before and after operation has no significant difference between two groups （P>0.05）; MyD88 and IRF7 mRNA in PBMCs and pDCs before and after operation in reactivation group were lower than non-reactivation group （P<0.05）; IRAK1, TRAF6, TAK1 mRNA in PBMCs and pDCs before and after operation in two groups had no significant difference before and after operation （P>0.05）. AUC of MyD88 mRNA combined with IRF7 mRNA in postoperative pDCs was greater than that in postoperative PBMCs. Conclusion: MyD88 and IRF7 mRNA in PBMCs and pDCs are related to viral reactivation after HBV infection-related liver cancer surgery, whose combination detection can provide a reference for clinical prediction of viral reactivation. [ABSTRACT FROM AUTHOR]

Zhanjie Li,1 Ying Zhang,2 Weihong Zhang,1 Yongxiang Zhang,1 Suming Zhou,3 Wensen Chen,1 Yun Liu4,5 1Department of Infection Control, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China; 2Department of Infection Control, Lianshui County People’s Hospital, Huaian, People’s Republic of China; 3Department of Geriatric Critical Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China; 4Department of Information, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China; 5Department of Medical Informatics, School of BioMedical Engineering and Informatics, Nanjing Medical University, Nanjing, People’s Republic of ChinaCorrespondence: Wensen Chen, Department of Infection Control, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China, Tel +86-13809049855, Email wensenchen@njmu.edu.cn Yun Liu, Department of Information, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guang Zhou Road, Nanjing, People’s Republic of China, Tel +86-18805152008, Email liuyun@njmu.edu.cnObjective: To analyze the infection and distribution of multidrug-resistant organisms (MDRO) in different clinical specimens, thereby providing a reference for clinical diagnosis and treatment and prevention and control.Patient and Methods: 2314 strains of MDRO isolated from clinical specimens in the First Affiliated Hospital of Nanjing Medical University from January to December 2020. MDRO were collected by Information System. The detection rate of MDRO, infection rate, the proportion of infection, and detection rate of MDRO infection in different specimens were analyzed.Results: The top three specimens in the detection rate of MDRO were BALF (60.71%), sputum (33.68%), and blood (28.79%). The top three specimens in the proportion of MDRO infection were blood (97.74), other sterile body fluids (90.35%), and BALF (90.20%). The top three specimens in the MDRO infection rate were BALF (9.75%), sputum (3.07%), and secretions (2.90%). The top three specimens in the detection rate of MDRO infection were sputum (0.63‰), other sterile body fluids (0.13‰), and secretions (0.11‰).Conclusion: The detection and infection distribution of MDRO vary greatly in different specimens. The submission of sterile body fluids for examination should be strengthened and the standard of sample collection should be highlighted.Keywords: different specimens, MDRO, detection rate, infection, sterile body fluids